06070034 CITY OF CUPERTINOa t'h° +'a ,v"k+tP �
BUILDING DIVISION PERMIT ON, IT' R �`�,����Z� '
BUILDING ADDRESS: R RUUYINU & OONSTRUCTIO P`TMZf 0'06070034
7569 KIRWIN LA
OWNER'S NAME: PERMITLSSUEDATE
NIAN ZHOU 15230 CLYDELLE AVENUE 07/10/2006
NE: SANITARY NO. CONTROL NO.
(408) 626-9320
ARCHIIECT(ENGINEER: BUILDING PERMIT INFO
BLDG ELECr PLUMB MECH
)oo LICENSED CONTRACTORS DECLARATION Job Description
I I hereby afOm that I am Ilcoased under Providers of Chapter 9(commencing p
with OfM3)ofDlN.ionSoflhoBunressandPrafcsaiom�C1oded.,and mylicett¢b REMOVE EXISTING WOOD SHAKE INSTALL NEW 30# FELT
a� i mmsearto end effect � a1
? License C
)� Date Gante�I STEEL TILE CLASS A
ARCHITE> 3 _`
fC Iundcx and yplms.Ialho uuda put,c
)yU
co Liccnud Pmfc.amr.1
OWNER-BUILDER DECLARATION
<� I hereby 417firm that I am exemphlrom-petth`tracmh License Law for the
a 0 following reason.(Scullion 7031.5,Business and Professwas Cade:Any city or county
5$ which requires a permit as construct,alter,impnrve.doemlbh,ar copes any stmctum
prior to its issuance.also requires the applicant for uch Permit to rile a signed statement
< that he is licensed pursuant to the provisions of the Contractors Licone Live(Chapmr 9 Sq. Ft.Floor Area Valu 0 0 0
555 C (commencing with Section 7M)of Division 3 of the Business and Professions Code)or
(e3$
that he Is accept therefrom artd the bub for the alleged esmnpde.Any violation of
Section 7031.3 by any applicant for a permit xbjecu the appilem t an a civil penalty ofppN 3�117er Occupancy Type
not marc Nan five hundred dolWa(g5M. 3S�J2 4
❑1,on owner of the property,or my employee,with MrA as their sole compensadon,
will do the work and the structure boot Intended or offered far talc(Sec.7044.Bunnrfa p$ n W
and Rty hens Cade:Th Comrxufa nd who LAW dao et apply m an aver is
Property he s.pro rk lmpsowadarm r and who daosuchwort hMselfor Nmagh his
however,
Om uiprnWdW that such nt isowmeu art not ear medore oraffermpictoed Tarsale B, �F
however,piebuilJintnsImpmwmmtbmid within am idormmpkdm,ritemver-
b le.). ME lave Lha burdrn of proNng Nat he did et build or improve for pugax of
axle.) and
❑1,as ower of project
Sec.704 am shmm,a lid contracting with Barred comacnies U.
construct Tho es not (Sec.7014,wnebm and ry,who
Cade:) pr Coouaemfs LI-
cense Loa dmf not apply m as oamer of pmpeny,oho sed P or impmw Thereon.and
who am Lace for such projects Mass tantracto(s)Ikcued pursuant x the Canlrsetor's
LJcove Law.
❑lson exempt undo See ,BkPCfor this reason
Ower Date
WORKER'S COMPENSATION DECLARATION
1 hereby alRm under penalty of perjury am of the following dedomdons:
.T wondwillmainainaC.efic.mof Cansentmulf-insumforWarter'sCompen-
s n,x provided for by Section 3700 of the Labor Cade,lm Ne part...of Ne
ark for which this permit Is Wue&
1 haw and will malnuin Warkeh Campeneatlan Imurance,u required by Section
3 of Ne lfbOr Code.for Ne performanco of the work for wMcb Nb permit4issuetl.
My r' pen�dan urance<articr antl Policy
er art:
Cartier. Poliry No.:
CERTIFICATEOF EMPTION FILO
COMPEN '
TION INSURANCE
(7btsxmlan rcedetbecoan Ietedifthe pm
chbforomhundmddaBan(5100)
or lex.)
1 certify that In was performance of de work for which NB permit is issued.I shall not
employ any person in any m urerm as or become subject to the Work m'Compartmen
Laws of Cnilomis.Dau
Applicants
NOTICE TO APPLICANP.If,sour making this OcNfiute of Exemption.your should
become subject to th<Worker's Compensation provisions of the LAhOr Cade,you muss
0z forthwith comply WIN such proMsiae Or Nb permit shall b:demand re
mwked.
yc CONSTRUCTION LENDING AOENCY
(•" I Wmhy affirm that them is construction lending agency for de pcdormame of
ai the work far which this permit is issued(Sec.3097.Ch.C.) '
W Q Undoes Nurse
a Z Lender's Address
U Q 1 certify that I haw read two application and sue WI Ne above information is
Li. P correct I agree to comply with all city and county Ordinances and state laws missing in
O U building convection,and hereby authorire repmscnmives of this city to enter upon the
W shove-racy ticamd pm,,Iy for inspection purpose..
gy
(Wo)agree to sow,indemnify and Inept harmless Nc City of Cupertino against
t•r h
liabilities judgments,costs and.open=which may In any Way accrue against and City
U,z in consequence of the granting of this permit,
APPL' DERSTAND A LL COMPLY WITH ALL NON-POINT Issued by: Date
6SOURCER ON . �n
1" /' y7�E MATERIALS �A�I �vl(1�7 Re-roofs
Signmuxgr poli Ontmmr k Dow
TYpe of Roof
•�/��yARD�buildig auvpenlsmm ar handle hamNous mmunal
as tle0ed by pe Cupertino Munki Cade.Chapter 9.11,and the Health and Safety
Cade,Secpaa 15531(.)] All roofs shall be inspected prior to any roofing material being installed.
141 ❑Yu o
Will the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit huardnu air cemamlunu defibed by the BayAma Air QWllly Management all.new materials for inspection.
District?
❑Yes ❑No
I have mad the humd.materials nquiremcwmukr Chapw&95 aftho Calif.r-
nu "Sormyeade Snetions15505.15533 and 15534.1 understand then lfte bolding
nx wrawu mar my,restomi liry m mofy the occupant of Ne
con eMa '�ofa &ueafoc Signature of Applicant Date
w
o m tamadacd.got Date All roof coverings to be Class "B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY Of Fax(408)777-3333
OJPEI�TINO
Building De artment
JOB ADDRESS: �/ 1� w , i LA�< PERMIT *
OWNER'S NAME: to Z!JWN PHONE # _l/01 2�-Z C7
GENERAL CONTRACTOR: , r FAX #
I am not using any sucontractor
ignature Date
Please check a licable su on complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
• Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
•em 2 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35921004 . 00
DATE ISSUED. . . . . . . : 07/10/2006
RECEIPT # • . . . . . . . . : 35154
REFERENCE ID # . . . : 06070034
SITE ADDRESS . . . . . : 7569 KIRWIN LA
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : NIAN ZHOU
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : RE ROOFING
CONTRACTOR . . . . . . . : PROCTOR, PAUL LIC # 20615
COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 15230 CLYDELLE AVENUE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE . . . . . . . . : (408) 626-9320
OEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 14 , 000 . 00 212 . 76 0 . 00 212 . 76 0 . 00
BSEISMICRE VALUATION 14 , 000 . 00 1 . 40 0 . 00 1 . 40 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 214 . 16 0 . 00 214 . 16 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 428 . 32' 10111
TOTAL RECEIPT 428 . 32
•
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• Telephone: (408)777-3228
Fax: (408)777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed, a plywood nail inspection is required.
• 6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will complyIlwith the above stated policy on re-roofing.
Homeowner's Name: N t\,kyv -2NUI
Job Site Address: �J� l K( ,w i d
I CEJ �� I
Roofing mpany Nam . V1UUl 1 iJ 6 QN, hl C
�1i 10
ApplicantCs Signatu\ re: �- --- Date: 0
-• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
AMA REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# 35� _ _ �,� Date:
Building Address:
5 i 0wW �
Owner's Name: �t A N ? TOT
-
Contractor• Iw U License#: 2 1 5 4 1
OAF �u I
Contact: / Cupertino Business License #:
2-06 S
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
O Wood Shingles ❑ Wood Shingles
❑ Other(Specify) Other(Specify) 1'
Number of existing coverings Provide I.C.B.O. Report# -
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read; Understand and Will Comply With Cu ertino's Tear Off Policy:
Job DescriptionTq4jm� (SfIW1 - V`ou $�}} L Nbtm lelGy�l '50'0 k-1-T
K
Residential Commerdial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions: LJ
Eff
Proj� p�u yU Type of Construction: Occupancy group:
26 PI
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING